title: Ambulation and complications related to assistive devices after spinal cord injury.
abstract: OBJECTIVE
  To evaluate long-term health outcomes including pain intensity, pain interference, and fatigue among ambulatory persons with spinal cord injury (SCI).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Data were analyzed at a major medical university in the southeast USA.
  
  
  METHODS
  Participants included 783 ambulatory adults with SCI of traumatic origin, who were at least 1-year post-injury. Participants were identified through three sources of records at a large specialty hospital in the southeastern USA.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Pain intensity and interference (Brief Pain Inventory) and fatigue (Modified Fatigue Impact Scale Abbreviated Version 5).
  
  
  RESULTS
  Examining assistive devices used for ambulation, 66% of the population used at least one device. In the logistic model, wheelchair and cane usage were significantly related to the outcomes after controlling for age, gender, and race. Wheelchair usage 50% of the time or less was significantly related to pain intensity (odds ratio (OR) 2.05, 95% confidence interval (CI) = 1.39-3.03), pain interference (OR 2.11, 95% CI = 1.43-3.12), and fatigue (OR 1.99, 95% CI = 1.12-1.43). Additionally, unilateral cane use was significantly related to the outcomes; pain intensity (OR 1.86, 95% CI = 1.35-2.56), pain interference (OR 2.11, 95% CI = 1.52-2.93), and fatigue (OR 2.49, 95% CI = 1.52-4.08).
  
  
  CONCLUSIONS
  Among ambulatory persons with SCI, increased pain intensity, pain interference, and fatigue are associated with minimal wheelchair usage (50% or less) and less supportive assistive device (unilateral cane) usage.
authors.affiliation: Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Lee L
authors.initials: LL
authors.lastname: Saunders
authors.affiliation: Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Krause
authors.affiliation: Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: DiPiro
authors.affiliation: Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Kraft
authors.affiliation: Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Brotherton
mesh_terms: D002183:Canes / Q000009:adverse effects*; D015331:Cohort Studies; D003625:Data Collection; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D013119:Spinal Cord Injuries / Q000150:complications*; D014853:Walkers / Q000009:adverse effects*; D014910:Wheelchairs / Q000009:adverse effects*